I read with great interest this review study titled: “Cocoa, Glucose Tolerance, and Insulin Signaling: Cardiometabolic Protection” and published in the Journal of Agriculture and Food Chemistry by Ferri el al. The authors expand on a key ingredient in cocoa, a flavonol known as oligomeric procyanidins. This particular antioxidant has protective properties against obesity and diabetes, making dark unprocessed chocolate the perfect desert for our patient population. Dark chocolate as opposed to milk chocolate is higher in cocoa content. It is more bitter than milk chocolate due to the higher content of flavonols. Highly processed chocolates like white chocolate have no flavonols at all and lack therefore the cardio-metabolic protective effects of cocoa. Most American chocolate is highly processed, and rich in vegetable oil, sugar and preservatives. We encourage our bariatric patients to avoid candies, and other sweet items before and after weight loss surgery. Sugar addiction is a real and common problem we encounter on a daily basis at Houston Weight Loss and Surgery Center. Overcoming the sweet tooth habit is a difficult hurdle to most of us. One way for curbing our appetite for sugar is to snack on dark chocolate. Consuming dark chocolate in moderation and on a daily basis reduces insulin resistance, decreases appetite, lowers blood pressure and prevents weight gain.

Experiments in mice maintained on different diets, showed that adding cocoa flavonol made the biggest difference in improving glucose tolerance and keeping the mice weight down. The effect of cocoa falvonol on gastrointestinal motility as well as neuro-endocrine hormone secretion like GLP-1 and Ghrelin has not been studied yet. We hope future studies will evaluate this potential interaction as it may be used as an effective weight loss and diabetes medication. For now however, we encourage our patients to enjoy dark unprocessed chocolate to improve their health before and after bariatric surgery